Instacool Cream
Neostigmine Methyl Sulphate
30%+8%
Medicon Pharmaceuticals Ltd.
| Pack size | 25 gm |
|---|---|
| Unite Price | 59.00 BDT |
Indications
Instacool Cream is used for:
Myasthenia gravis, Paralytic ileus, Post-op urinary retention, Reversal of nondepolarising neuromuscular blockade
Adult Dose
Parenteral
Myasthenia gravis
Adult: 0.5-2.5 mg by IM or SC inj, doses are given at intervals according to response up to a total daily dose of 5-20 mg.
Paralytic ileus and postoperative urinary retention
Adult: 0.5-2.5 mg by SC or IM inj, as required.
Reversal of neuromuscular blockade
Adult: 0.03-0.07 mg/kg by inj over 60 sec, as required.
Not to exceed 0.07 mg/kg or a cumulative total of 5 mg, whichever dose is less Inject by slow IV over at least 1 minute
Child Dose
Parenteral
Myasthenia gravis
Child: <12 yr 0.2-0.5 mg, repeated at suitable intervals throughout the day.
Paralytic ileus and postoperative urinary retention
Child: 0.125-1 mg by SC or IM inj.
Intravenous
Reversal of neuromuscular blockade
Child: 0.05-0.07 mg/kg by inj over 60 sec, as required.
Intramuscular
Neonatal myasthenia gravis
Child: Initially, 0.1 mg, followed by 0.05-0.25 mg or 0.03 mg/kg 2-4 hrly.
Renal Dose
Renal impairment: Dose adjustment may be required.
Administration
Contra Indications
Mechanical GI or urinary tract obstruction, peritonitis.
Precautions
Patient w/ bronchial asthma, CV disorders (e.g. bradycardia, recent MI, hypotension), peptic ulcer disease, vagotonia, epilepsy, parkinsonism, hyperthyroidism. Patient who underwent recent intestinal or bladder surgery. Renal impairment. Childn. Pregnancy and lactation. Monitoring Parameters Monitor ECG, BP and heart rate esp w/ IV use.
Lactation: Unknown if distributed in human breast milk; use caution
Pregnancy-Lactation
Pregnancy: There are no adequate or well-controlled studies in pregnant women; not known whether neostigmine can cause fetal harm or affect reproductive capacity; should administer only if clearly needed
Lactation: Unknown if distributed in human breast milk; use caution
Interactions
May reduce effects of anticholinergics. May increase effects of cholinergic agonists. Increased risk of bradycardia with digoxin, diltiazem, verapamil or beta-blockers without intrinsic sympathomimetic activity. Increased muscle weakness and decreased response to anticholinesterases with corticosteroids. May increase effects of depolarising neuromuscular blockers. Effects may be antagonised by drugs with neuromuscular blocking activity e.g. aminoglycosides, clindamycin, colistin, cyclopropane, halogenated inhalational anaesthetics. Effects may be reduced by quinine, chloroquine, hydroxychloroquine, quinidine, procainamide, propafenone, lithium, beta-blockers. Possible additive toxicity with ophthalmic use of anticholinesterases e.g. ecothiopate.
Side Effects
Side effects of Neostigmine Methyl Sulphate :
Allergic: Allergic reactions and anaphylaxis
Neurologic: Dizziness, convulsions, loss of consciousness, drowsiness, headache, dysarthria, miosis and visual changes
Cardiovascular: Cardiac arrhythmias (including bradycardia, tachycardia, A-V block and nodal rhythm) and nonspecific EKG changes have been reported, as well as cardiac arrest, syncope and hypotension (predominantly with parenteral dosage form)
Respiratory: Increased oral, pharyngeal and bronchial secretions, and dyspnea; respiratory depression, respiratory arrest and bronchospasm have been reported following the use of the injectable form
Dermatologic: Rash and urticaria
Gastrointestinal: Nausea, emesis, flatulence, and increased peristalsis and salivation
Genitourinary: Urinary frequency
Musculoskeletal: Muscle cramps and spasms, arthralgia
Miscellaneous: Diaphoresis, flushing and weaknes
Potentially Fatal: Anaphylaxis.
Mode of Action
Neostigmine reversibly inhibits acetylcholinesterase and thus potentiates the nicotinic and muscarinic effects of acetylcholine. This facilitates the transmission of impulses across myoneural junction.
Note
Instacool 30%+8% Cream generic name is Neostigmine Methyl Sulphate. Instacool 30%+8% Cream is manufactured by Medicon Pharmaceuticals Ltd.Instacool is availble in all over Bangladesh.
Mes BD drug index information on Instacool Cream is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.